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General NPI Number Information
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NPI Number | 1609173970
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Entity Type | Organization
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Legal Business Name | ANGLESEY FAMILY CHIROPRACTIC & MASSAGE CENTER
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 500 S PINES RD
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-5324
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Country | US
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Telephone | 509-927-8881
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Fax | 509-891-6281
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Provider Business Mailing Address
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Address Line | 500 S PINES RD
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-5324
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Country | US
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Telephone | 509-927-8881
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Fax | 509-891-6281
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. CRAIG D ANGLESEY
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Credential | DC
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Telephone | 509-927-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00022059
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 34347
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License Number State | WA
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